This study will first describe the development and implementation of federal child health policy under Medicaid with particular emphasis on the organization, distribution, and financing of health services under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program. Second, the study will analyze four major constraints affecting implementation of this federal policy: a) differences in health and welfare agency ideologies which lead to conflicts of roles and responsibilities; b) lack of consensus among health professionals regarding the benefits of preventive care; c) federal inability to enforce its laws and regulations in the states; and d) absence of state managerial ability to handle effective case-management. Data will be gathered from federal and state agencies, supplemental reports, reviews of relevant literature, Medicaid payment tapes of Connecticut, and national data on expenditures and services from the Medical Services Administration (MSA) of the Social and Rehabilitation Service (SRS). To supplement documentary data, systematic interviews wll be held with key officials in the federal government and in the two states selected for study.